Saunders Respiratory Practice

Which recommendation should be given to a client with emphysema to enhance breathing during dyspnea?

1. Sit upright without support

2. Stand with hands on hips

3. Sit on the side of the bed leaning on an overbed table

4. Lie flat on the bed with pillows

The correct answer is: Sit on the side of the bed leaning on an overbed table

Recommending the client with emphysema to sit on the side of the bed leaning on an overbed table is beneficial because it allows for optimum lung expansion and diaphragmatic movement. This position can facilitate the use of gravity to aid in lung mechanics, making it easier for the individual to breathe. By leaning forward, the patient can also reduce abdominal pressure on the diaphragm, which can help to improve airflow and decrease the work of breathing. This position has a stabilizing effect on the upper body, allowing the individual to utilize accessory muscles of respiration more effectively while maintaining a degree of support. It promotes a posture that opens the thoracic cavity, enhancing lung ventilation during episodes of dyspnea, which is a common symptom in emphysema due to the destruction of alveoli and impaired gas exchange. In contrast, sitting upright without support may provide some benefits but could increase discomfort or strain in some patients who require additional support. Standing with hands on hips may not offer the necessary relaxation and support for breath control. Finally, lying flat on the bed with pillows can lead to increased abdominal pressure on the diaphragm, potentially worsening breathing difficulty, particularly in patients with chronic obstructive pulmonary disease like emphysema.